cefadroxil

cefadroxil /cef·a·drox·il/ (sef?ah-droks´il) a semisynthetic first-generation cephalosporin antibiotic effective against a wide range of gram-positive and a very limited number of gram-negative bacteria.

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cef·a·drox·il (sf-drksl)

n.

A semisynthetic, broad-spectrum antibiotic derived from cephalosporin with action similar to the penicillins.

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cefadroxil (sef´drok´sl),

n brand names: Duricef, Ultracef;
drug class: first-generation cephalosporin;
action: inhibits bacterial cell wall synthesis, rendering cell wall osmotically unstable;
uses: eradication of gram-negative bacilli from the upper and lower respiratory tracts, and treatment of urinary tract and skin infections and otitis media.

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cefadroxil

a first generation cephalosporin antibiotic.

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cefadroxil

Baxan (UK), Duricef, Novo-Cefadroxil (CA)

Pharmacologic class: First-generation cephalosporin

Therapeutic class: Anti-infective

Pregnancy risk category B

Action

Interferes with bacterial cell-wall synthesis, causing cell to rupture and die

Availability

Capsules: 500 mg

Oral suspension: 125 mg/5 ml, 250 mg/5 ml, 500 mg/5 ml

Tablets: 1 g

⊘Indications and dosages

➣ Pharyngitis and tonsillitis caused by beta-hemolytic streptococci

Adults: 1 g/day P.O. or 500 mg P.O. b.i.d. for 10 days

Children: 30 mg/kg/day P.O. in divided doses q 12 hours for 10 days

➣ Skin infections caused by staphylococci and streptococci

Adults: 1 g/day P.O. or 500 mg P.O. q 12 hours

Children: 30 mg/kg/day P.O. in divided doses q 12 hours

➣ Urinary tract infections caused by Proteus mirabilis, Escherichia coli, and Klebsiella species

Adults: 1 to 2 g/day P.O. in divided doses q 12 hours

Children: 30 mg/kg/day P.O. in divided doses q 12 hours

Dosage adjustment

• Renal insufficiency
• Elderly patients

Off-label uses

• Bone and joint infections
• Unspecified respiratory infections

Contraindications

• Hypersensitivity to cephalosporins or penicillins

Precautions

Use cautiously in:
• renal impairment, phenylketonuria
• history of GI disease (especially colitis)
• elderly patients
• pregnant or breastfeeding patients
• children.

Administration

• Obtain specimens for culture and sensitivity testing as necessary before starting therapy.
• Give with or without food.

Route	Onset	Peak	Duration
P.O.	Rapid	1.5-2 hr	12-24 hr

Adverse reactions

CNS: headache, lethargy, paresthesia, syncope, seizures

CV: hypotension, palpitations, chest pain, vasodilation

EENT: hearing loss

GI: nausea, vomiting, diarrhea, cramps, oral candidiasis, pseudomembranous colitis

GU: vaginal candidiasis, nephrotoxicity

Hematologic: lymphocytosis, eosinophilia, bleeding tendency, hemolytic anemia, hypoprothrombinemia, neutropenia, thrombocytopenia, agranulocytosis, bone marrow depression

Hepatic: hepatic failure, hepatomegaly

Musculoskeletal: arthralgia

Respiratory: dyspnea

Skin: urticaria, maculopapular or erythematous rash

Other: chills, fever, superinfection, anaphylaxis

Interactions

Drug-drug. Aminoglycosides, loop diuretics: increased risk of nephrotoxicity

Probenecid: decreased excretion and increased blood level of cefadroxil

Drug-diagnostic tests. Alanine aminotransferase, alkaline phosphatase, aspartate aminotransferase, bilirubin, blood urea nitrogen, creatinine, eosinophils, gamma-glutamyltransferase, lactate dehydrogenase: increased levels

Coombs' test, urinary 17-ketosteroids, nonenzyme-based urine glucose tests (such as Clinitest): false-positive results

Hemoglobin, platelets, white blood cells: decreased values

Patient monitoring

• Assess baseline CBC and kidney and liver function test results.
• Monitor for signs and symptoms of superinfection and other serious adverse reactions.
• Be aware that cross-sensitivity to penicillins may occur.
• With long-term therapy, obtain monthly Coombs' test.

Patient teaching

• Advise patient to take drug with food or milk if GI upset occurs.
• Instruct patient to complete entire course of therapy even if he feels better.
• Tell patient to report signs and symptoms of allergic response and other adverse reactions, such as rash, easy bruising, bleeding, severe GI problems, wheezing, or difficulty breathing.
• As appropriate, review all other significant and life-threatening adverse reactions and interactions, especially those related to the drugs and tests mentioned above.